BACKGROUND: Whether gender affects patient satisfaction is still debated. This article focuses on methodological issues in analysing gender differences with emphasis on factors like age and educational level. MATERIAL AND METHODS: 1,469 male and 1,226 female patients returned a questionnaire six weeks after discharge from hospital. Gender differences in satisfaction were examined by multiple regression analysis. RESULTS: The weak gender difference that occurred in overall satisfaction was due to a significant gender difference between young patients' assessment of the quality of nursing care. For patients over 35, there was no gender difference in satisfaction. INTERPRETATION: Gender differences in patient satisfaction are not straightforward, but vary according to underlying cultural and social factors.